原发性睾丸胚胎癌的MRI/CT诊断价值  

The Value of CT and MRI in Diagnosing Primary Testicular Embryonal Carcinoma

作　　者：龙德云[1] 潘建伟[1] 高芙蓉[1] 柳杰[1] 张福刚[1] 陈明安[1] 

机构地区：[1]武警浙江省总队医院放射科,嘉兴314000

出　　处：《临床放射学杂志》2015年第4期652-655,共4页Journal of Clinical Radiology

摘　　要：目的探讨原发性睾丸胚胎癌（PTEC）的临床特点和MRI/CT表现,拟提高对该病的诊断能力。方法结合国内外相关文献,回顾性分析7例经手术和病理证实的睾丸PTEC患者的临床资料和MRI/CT表现,并与病理结果对照。结果 7例PTEC患者表现睾丸渐进性肿大1周-5个月,质硬7例,表面结节感6例,光滑1例;肿瘤最大径7-10 cm,7例均因有出血、坏死,MRI或CT表现为混杂不均匀信号或不均匀密度,4例CT检查见条形钙化,附睾或精索受累2例,后腹膜腔淋巴结转移4例,远处脏器转移4例;7例PTEC中Ⅰ期1例,Ⅱ期2例,Ⅲ期4例;全部行根治性睾丸切除术和腹腔镜下后腹膜淋巴结清扫术。结论睾丸胚胎癌生长快,体积巨大,转移早,其临床和MRI/CT表现有一定的特点;MRI/CT对睾丸胚胎癌的诊断和临床分期有重要的临床价值。Objective To investigate MRI/CT features and the clinical manifestations of primary testicular embrynnal carcinoma （PTEC） in order to improve the diagnostic level of this disease. Methods Combined with the relevant medical literature recently published at home and abroad, the MRI/CT findings and clinical manifestations of 7 patients with surgically and pathologically confirmed PTEC were retrospectively analyzed, and the data were compared with the pathological results. Results In seven patients with PTEC, the testis showed progressive enlargement during a period of one week to 5 months ; the testicular texture was hard in 7 patients ; on palpation of the testis the testicular surface gave a nodular sense in 6 patients and smooth feeling in one patient. The maximum diameter of the tumors ranged from 7 cm to 10 cm; hemorrhage and necrosis were observed in all 7 patients, which presented as mixed inhomogeneous signals on MRI and uneven density shadow on CT scan. CT scan demonstrated strip calcification in 4 patients, involvement of epididymis or spermatic coM was found in 2 patients, retroperitoneal lymph node metastasis was detected in 4 patients and distant metastasis in 4 patients. Of the 7 patients with PTEC, stage Ⅰ, Ⅱ and Ⅲ was seen in one, 2 and 4 patients respectively. Radical orchiectomy and laparoseopie clearance of retroperitoneal lymph nodes were carried out in all patients. Conclusion Embryonal carcinoma of the testis is characterized by its fast growing, large volume and early metastasis. PTEC has certain clinical and MRI/CT characteristics. MRI/CT has an important clinical value in diagnosing and staging PTEC.

关 键 词：睾丸肿瘤 胚胎性 诊断价值 磁共振成像 体层摄影术 X线计算机 

分 类 号：R737.21[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2